The Effect of Obesity on Outcomes of Ventral Hernia Repair: A Propensity Score Matching Analysis

Borad, Neil P.; Merchant, Aziz M.

doi:10.17756/jocd.2016-003

Cited by 1 publication

(1 citation statement)

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“…The mechanism for an increased risk of recurrent hernia in patients could range from technical factors, increased intra-abdominal pressure, abnormal distribution of fat or reduced muscle mass. Obesity may also have indirect effect on recurrence by increasing the risk of surgical site infection [ 3 ]. Muscle mass may also be affected by previous incisional hernia repair as a result of vascular or nerve damage from multiple repairs.…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous and visceral adipose tissue in patients with primary and recurrent incisional hernia

Qandeel

Chew

Young

et al. 2021

Hernia

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Purpose Visceral obesity rather than body mass index has been reported to be associated with a higher incidence of incisional hernias. The aim of this study was to examine the relationship between CT measured adipose tissue and muscle in primary and recurrent incisional hernia. Methods Patients with a ‘Primary’ or ‘Recurrent incisional hernia’ were obtained from a prospective cohort of patients who were being assessed for incisional hernia repair over a 2-year period. Computerised tomography (CT)-images were analysed using NIH Image-J software to quantify adipose tissue and skeletal muscle cross-sectional areas at the level of lumber vertebra 3/4 using standard Hounsfield units. To test inter-observer ‘absolute agreement’, each parameter was measured independently by two investigators and reliability analysis performed. Results Thirty-six patients were included in the study: 15 had a Primary while 21 had a Recurrent incisional hernia. Both groups had similar baseline characteristics. Reliability analysis for CT-measured areas showed very high interclass correlation coefficient (ICC) between observers. Patients in the recurrent group had significantly greater subcutaneous adipose tissue (SAT) [median = 321.9cm2 vs 230.9cm2, p = 0.04] and visceral adipose tissue (VAT) [median = 221.1cm2 vs 146.8cm2, p = 0.03] than those in the primary group. There was no difference in skeletal muscle areas for right [median = 2.8cm2 vs 2.9cm2] and left [median = 3.7cm2 vs 4.1cm2] rectus muscles between groups. Conclusion Our study shows that patients with a recurrent incisional hernia have significantly more subcutaneous and visceral adipose tissue than those with a primary incisional hernia. Further studies in this area are required if we are to reduce the burden of recurrent hernia following repair of a primary incisional hernia.

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Section: Introductionmentioning

confidence: 99%